Question: 85 yr old male, metastasized kidney cancer, plural effusion with permanent drain getting 600 ml three times a week. Swollen ankles. Auxiliary lymph node just removed and positive for cancer last week. First time in two years matastisized distant. Oxygen and blood pressure and heart rate currently normal range. However, he is extremely weak and extremely fatigued. Dr put him on toprol 100 2x per day when his heart rate was up during lymph removal. Not started on chemo because dr wanted drain in first. Could toprol be too strong causing this weakness/fatigue? He is 170 lbs and I believe he was not this weak prior to raising of toprol from 50 to 100. The dr who originally prescribed it at 50 questioned why he was on 100 but hesitated and did not lower.

We have an appt with the lung drain and lymph node removal dr XXXXXXX The electrical heart dr originally gave him the
50 toprol 2x a day. A random hospital dr gave him the 100 2x a day while he was in hospital one night after the lymph surgery. And the original dr didn't change it. Plus he has his oncologist who the dr who found the cancer in the lymph node was going to call and we don't know if he did. Plus he has his regular cardiologist.
So for these two weeks since the positive lymph node surgery and raised toprol
He has become very very weak and fatigued. But does have normal oxygen blood pressure and heart rate. But he does not feel well he was active with some weakness before the lymph node surgery. Sorry for not knowing correct
Names of the types of Drs. We were going to ask the dr XXXXXXX if he can change the toprol (again he is the lung drain dr) or if he can't if he can get him into the electric dr who originally put him on it. They all work out of same hospital. We don't know if oncologist is in the loop.
Two questions if you can follow me
1. Who should we go to? None of these Drs know what the other is doing he has so many issues. CHF, swollen ankles, metastatic kidney cancer....and obviously his quality of life is going downhill but really all of a sudden he's had all these things for two years. I know your sort of guessing but who do we go to? Or at least start with? His gp has also been in the loop during the last few weeks. I really do feel it's the toprol because before that he was not like this.
This leads to my second question...or do you think it is the cancer moving quick now and causing this?
I do understand he has many end of life symptoms but he was doing decent until this last auxiliary lymph node surgery which was positive.
I have probably more than two questions in here do you think it is the toprol

What dr should we see or should we do them all or should we just go to hospital? Or since we have the lung drain dr appt XXXXXXX just start there?

And lastly or do you think it is the cancer and he needs hospice or palliative care?

I should mention he still will ride and go to store even though he know stays in car and his mind is still sharp. He is not bedridden now at all.
Sorry for being rambling but have to do this on my phone so it is a little tough.